Kelli Donahue Bentsen

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT023939 Issued in PA

Practice address

1010 Brooks Bay Dr
Erie, PA 16505-5706

Phone

(252) 213-0001

Fax

(919) 693-9381

NPI assigned

Feb 2, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Abc Pediatric Therapy, LLC

  • Early Intervention Provider Agency
  • Oxford, NC
  • NPI 1124086822

  Physical Therapist

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1063550002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 BROOKS BAY DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165055706",
            "telephone_number": "252-213-0001",
            "fax_number": "919-693-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 BROOKS BAY DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165055706",
            "telephone_number": "252-213-0001",
            "fax_number": "919-693-9381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Old Warehouse Square",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "NC",
            "postal_code": "27565",
            "country_code": "US",
            "telephone_number": "252-213-0001",
            "fax_number": "919-693-1671",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1330 W 26th St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165081402",
            "country_code": "US",
            "telephone_number": "252-213-0001",
            "fax_number": "919-693-9381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENTSEN",
        "first_name": "KELLI",
        "middle_name": "DONAHUE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT023939",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NC",
            "license": "8753",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IND #",
            "identifier": "078K3",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211010",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Bennett, LPC
• Jeffrey Alan Benson, D.M.D. , M.S.D.
• Jeremy P Benson, PT
• Maggie Benson
• Vanessa Benson, MA CCC-SLP/L
• Melanie R Bentz, PA-C
• Kevin Berceli, LPC
• Alexandra Berezan, MD
• Lindsey Patricia Berg
• Linda Jean Bergdahl, RDH

• All providers in Erie, PA
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.